Torticollis

Caitlin with young patient.
Posted July 23, 2021
Caitlin Williams
Physiotherapist
BKin(Hon), MSc(PT), MScCl(Manip Ther), DPT, FCAMPT

Taking care of a newborn can feel overwhelming at times. And searching Dr. Google during a 2am feeding can feel all the more frustrating and exhausting.

One of the conditions which we treat here at Elora Physiotherapy is torticollis. Torticollis is defined as, ‘the postural positioning that happens when a head is twisted and turned to one side.’(1) In other words, when a caregiver notices that his/her baby’s head is tilted to one side, and the baby is unable to correct it.

So, what causes torticollis? There are many things which can cause torticollis but most often it is related to a muscular abnormality; the muscle(s) which normally produce that movement are limited. (1) Torticollis can also occur after a traumatic or breech labour. And with currently technology, more infants are surviving these births, so we are seeing an increase in torticollis among newborns. (1)

Now at 2am when you are staring at your newborn, wondering if they may have torticollis, here are some common signs to look for (1):

  • Your babies head sidebends and rotates to the opposite direction
  • Skull or facial asymmetry
  • Jaw asymmetry
  • The baby has difficulty breastfeeding equally well on both sides
  • The eye or ear on one side is smaller
  • One shoulder is in a ‘shrugged’ position
  • Their trunk is bending towards one side

Fortunately, with the help of the baby’s caregiver(s), physiotherapy has been shown to be very effective in treating torticollis, especially if diagnosed early and the limitation in mobility is less severe. Early treatment is an important factor to their recovery because at a young age, their muscles are still pliable (2). Even though In very severe situations, surgery may be needed, but in 90% of cases infants do very well conservative treatments (3).

After a thorough assessment with your physiotherapist, they will determine a treatment plan which is best suited for your baby and the caregiver(s). Treatment options may include:

  • Using toys and sounds to encourage your baby to rotate and tilt their head
  • To work on ‘tummy time’ with your baby
  • To utilize certain positions which promote movement into the affected direction, i.e. feeding positions, placement of change table, carrying positions
  • Stretching (as advised by your physiotherapist)

Although infants do very well with physiotherapy to treat their torticollis, it is important to have a thorough assessment completed to make an accurate diagnosis. If you feel as though your newborn is showing signs of torticollis, don’t read into Dr Google at 2am. Instead call, Elora Physiotherapist and book an appointment or a free 10 minute consultation to discuss your newborn… or book online at 2am! And grab those moments of sleep when you can!

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References

1. Kuo AA1, Tritasavit S, Graham JM Jr. Congenital muscular torticollis and positional plagiocephaly.Pediatr Rev. 2014 Feb;35(2):79-87; doi: 10.1542/pir.35-2-79.

2. Carenzio G1, Carlisi E, Morani I, Tinelli C, Barak M, Bejor M, Dalla Toffola E. Early rehabilitation treatment in newborns with congenital muscular torticollis. Eur J Phys Rehabil Med. 2015 Oct;51(5):539-45

3. Suhr MC1, Oledzka M. Considerations and intervention in congenital muscular torticollis. Curr Opin Pediatr. 2015 Feb;27(1):75-81.